Active NPI
Shayla Dearborn
- Physical Therapist
- Conway, SC
National Provider Identifier
1881491215
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- CP049700T
- Practice address
- 300 Singleton Ridge Rd
Conway, SC 29526-9142 - Phone
- (843) 347-7111
- NPI assigned
- Feb 25, 2025
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | P23873 | NC | |
| Physical Therapist | 225100000X | CP049700T | SC | Primary |
Addresses
Primary practice location
300 Singleton Ridge Rd
Conway, SC 29526-9142
Mailing address
201 John Pridgen LN
Warsaw, NC 28398-8587
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| P23873 | NC | MD | Physical Therapist |
| CP049700T | SC | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1740441600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1759363200000",
"number": "1881491215",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "201 JOHN PRIDGEN LN",
"city": "WARSAW",
"state": "NC",
"postal_code": "283988587"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "300 SINGLETON RIDGE RD",
"city": "CONWAY",
"state": "SC",
"postal_code": "295269142",
"telephone_number": "843-347-7111"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DEARBORN",
"first_name": "SHAYLA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2025-02-25",
"last_updated": "2025-10-02",
"certification_date": "2025-10-02",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "NC",
"license": "P23873",
"primary": false
},
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "SC",
"license": "CP049700T",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Conway, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.